Hormone Therapy Options (Nursing)

00:00 Let's take a look at what those hormone therapy options are.

00:05 If a client is a trans woman, that means they are assigned male at birth, and they're identifying as female, they're going to take two types of hormone therapy.

00:15 They're going to take antiandrogens, right? Because those are going to block the male characteristics.

00:22 And they're going to choose to take estrogen, which will help them develop more female characteristics.

00:28 So they are assigned male at birth, they identify as female.

00:32 So in order to take on female characteristics, they're going to block the testosterone, antiandrogens, and they're going to receive estrogen to help them develop female physical characteristics.

00:45 Now, if a trans woman is considering a vaginoplasty with orchiectomy, they have to be some criteria that they usually meet.

00:53 Now a general guideline is they need to have been on hormone therapy for at least one year and they need to be greater than 18 years of age.

01:01 Now, this is often referred to in communities as bottom surgery.

01:06 So whether trans woman or trans male, the surgery of the involves a vaginoplasty or an orchiectomy.

01:13 That is called bottom surgery.

01:15 So first, you start with hormone therapy.

01:18 If you've been on that therapy for at least a year, and you're 18 years or older, then you can be considered for a vaginoplasty with orchiectomy if you prefer.

01:29 Now let's look at the other end of the spectrum.

01:32 Trans men, keep in mind they are assigned female at birth and they are identifying as male.

01:39 Their hormone therapy options include testosterone.

01:43 Now, the reason they take testosterone is because they're assigned female at birth.

01:48 And now we'd like to have more masculine or what is considered male characteristics.

01:53 That's why their hormone therapy is testosterone.

01:56 Same guidelines are applied to trans men as far as bottom surgery.

02:02 Their bottom surgery is a hysterectomy within oophorectomy.

02:07 Now, this is removal of the uterus and the ovaries.

02:11 They have to follow the same guidelines of having been on hormone therapy for at least a year and 18 years old or greater.

02:19 Here's the caveat I want you to know though, not all trans men decide to have a hysterectomy and oophorectomy.

02:27 In fact, some trans men carry a child to delivery full term.

02:34 So that's why you'll notice a change in the language instead of nursing classes being called maternal child, they're called child bearing families.

02:44 So don't be completely surprised or assume that someone who walks in for care if they have very masculine characteristics may actually be pregnant.

02:56 Now sex steroids play a significant role in bone growth.

03:01 And in this series, that's what we're looking at is osteoporosis in transgendered people.

03:07 So we're gonna dig down a little bit in the sex steroids because they play such an important role in what we're talking about which is bones.

03:15 So we've identified some of the terms and definitions so you feel more comfortable with what we're discussing.

03:20 Now we're going to talk about what is actually going on with the sex steroids.

03:24 So testosterone is a big one for maintaining bone tissue.

03:30 Now, if I'm a cis woman, estrogen is what plays that role.

03:35 So in cisgender men, testosterone is what helps keep strong healthy bones.

03:41 And in women, it's predominantly the sex steroid, estrogen.

03:46 Now, when a woman goes through menopause if a cisgender woman goes through menopause, they lose their estrogen, they have a lower level of estrogen and they increased osteoclast activity.

03:59 Okay, so why is that problematic? Well, osteoclast, right? Those are the ones that clean things up.

04:06 They kind of destroy the bone or dissolve the bone.

04:10 So a patient in menopause has less estrogen and will have an increase in the osteoclast activity, a cleaner activity, and they'll have a decrease in bone mineral density.

04:23 Okay, so in cisgender men, we're looking to the sex steroid of testosterone.

04:29 Cisgender women, it's estrogen and we wrote you a note there to remind you.

04:34 Menopause is problematic because women have far less estrogen.